Rural and Urban Differences in Children's Medicaid and CHIP Participation

Abstract

Efforts to increase enrollment in Medicaid and the Children's Health Insurance Program (CHIP) among uninsured children would benefit from an understanding of how program participation varies in rural and urban areas. Using Current Population Survey data from the period 2006–2007, rural participation rates were slightly higher than urban rates in the nation overall. There was no rural-urban difference when comparisons were based on within-state variation, independent of adjustment for individual characteristics. For researchers examining health policy issues strongly influenced by state policies or other state-level factors, this study highlights the challenges presented by national data sets with small or nonexistent samples from geographic areas within some states.

Running the Numbers

“…It is important to note that the estimates presented here are for potential eligibility, not for enrollment. It has been well documented that insurance programs rarely enroll 100% of eligible individuals [8,9]; however, the individual mandate included in the ACA should provide an incentive for people to enroll. It is also important to note that additional eligibility criteria are not incorporated into the SAHIE estimates (notably, the criterion that an individual must either be a US citizen or have been a resident of the United States for at least 5 years), so the presented rates are overestimates.…”